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General NPI Number Information
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NPI Number | 1114392172
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Entity Type | Individual
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Provider Name | ROBIN RAE HOFFELD CSFA
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Gender | Female
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 11401 WEDGEWOOD LN
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-7910
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Country | US
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Telephone | 228-380-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 11401 WEDGEWOOD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39532
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Country | US
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Telephone | 228-380-0201
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 162338
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License Number State | MI
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